Individual provider Active NPI

Selamawit Negusse, MD

  • Radiation Oncology Physician
  • Irvine, CA
National Provider Identifier
1316144041
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
25171 Issued in OK
Practice address
16100 Sand Canyon Ave Ste 130
Irvine, CA 92618-3722
Phone
(949) 417-1100
Fax
(949) 417-1165
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 25171 OK Primary

Addresses

Primary practice location

16100 Sand Canyon Ave Ste 130
Irvine, CA 92618-3722

Mailing address

16100 Sand Canyon Ave Ste 130
Irvine, CA 92618-3722
Phone (949) 417-1100

Other practice location 1

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR, CA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20111017000226 OK Practitioner - Radiation Oncology 7517139546 Reassigns benefits to 3 organizations
I20170106001343 AR Practitioner - Radiation Oncology 7517139546 Reassigns benefits to 1 organization
I20240919000870 CA Practitioner - Radiation Oncology 7517139546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kenneth M Tokita MD IncGroup PAC ID 0941389910, 2 clinicians
RK VasireddyGroup PAC ID 1355880840, 2 clinicians

Practice addresses (Care Compare)

16100 Sand Canyon Ave
Suite 130
Irvine, CA 92618-3722
Phone (949) 417-1100

301 N 32ND St
Muskogee, OK 74401-2106
Phone (918) 683-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25171OKMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 3, 2023 Accepting new patients
Saint Francis Hospital Muskogee Inc CurrentSince Jun 15, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Mar 3, 2023 Accepting new patients
Kenneth M Tokita MD Inc CurrentSince Sep 9, 2024 Accepting new patients
Warren Clinic Inc CurrentSince Apr 1, 2017 Accepting new patients
RK Vasireddy Radiation Oncology CurrentSince Nov 1, 2024 Accepting new patients

Locations

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

16100 Sand Canyon Ave
Ste 130
Irvine, CA 92618
Phone (949) 417-1100

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

2900 N Main St
Muskogee, OK 74401
Phone (918) 300-1320

301 N 32nd St
Muskogee, OK 74401
Phone (918) 683-2000

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1316144041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE STE 130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183722",
            "telephone_number": "949-417-1100",
            "fax_number": "949-417-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE STE 130",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183722",
            "telephone_number": "949-417-1100",
            "fax_number": "949-417-1165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Rockefeller Dr",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744015075",
            "country_code": "US",
            "telephone_number": "918-684-2187",
            "fax_number": "918-684-2196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEGUSSE",
        "first_name": "SELAMAWIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OK",
            "license": "25171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.